Dietary consideration for heart disease Sodium content of foods
Dietary consideration for heart disease
Sodium content of foods
Certainly, the most critical factor is that the patient eats. Diet changes during times of illness are not a good idea, it is better to wait until they are feeling better then gradually introduce any new food. It is best not to put medication in food as they can develop a food aversion or not recieve all their medication.
Sodium (Na) – There has been much discussion about low sodium diets in heart disease. The current recommendation is
1. Asymptomatic heart disease (isachc 1a) – mild sodium restriction (less than 100 mg/100kcal)
2. Mild heart disease(isachc 1b) – less than 80 mg/100kcal
3. Moderate heart disease (isachc stage 2) – 50-80 mg/100kcal
4. Severe heart disease and congestive failure – less than 50 mg/100kcal
Protein – it is common for muscle wasting to occur as heart disease progresses. This can be due to loss of appetite, increased energy requirement, increased production of inflammatory cytokines and “muscle-sparing” vascular shunting. A high quality (very bioavailable) protein should be fed, unless there is concurrent kidney or liver failure.
Canine – 5.1g/100kcal and feline – 6.5 g/100kcal.
Fat – Most canine and feline diet contain primarily n-6 fatty acids. Higher concentrations of N-3 fatty acids can be beneficial in reducing the production of cytokines and other inflammatory mediators. Current dosing recommendations are 40 mg/kg of EPA (eicosapentoic acid) and 25 mg/kg of DHA. Most capsules contain 180 mg of epa and 120 mg of DHA, so a dose of 1 capsule/10 pounds is used. Fish oil supplements should always contain Vitamin E as an anti-oxidant, but not other nutrients to avoid toxicity. Cod liver oil and flaxseed oil should not be used.
Supplements – Remember that dietary supplements do not require proof of safety, efficacy or quality control to be sold. If used, careful selection of type and brand should be employed. Regular cardiac medication or pharmaceuticals should always come first in terms of budget and administration.
Taurine – deficiencies of this can lead to dilated cardiomyopathy and were problematic in the 1980’s. The deficient diets have been corrected and this is less of a problem than before. Measurement of plasma and whole blood taurine concentrations is considered in dogs with DCM in at-risk breeds such as cocker spaniels, newfoundlands, golden retrievers or dogs that eat lamb meal and rice-based diets, high-fiber diets, or highly protein restricted diets. Supplementation at 500-1000 mg every 8-12 hours is current recommendation.
L-Carnitine– A family of boxers with dilated cardiomyopathy were found to be deficient from this in 1991. No blinded, prospective studies have been done in veterinary medicine at the time of this writing. A human study with DCM showed improved survival in patients recieving carnitine supplementation. Canine dose is 50-100 mg/kg orally every 8 hours.
Diets | kcal | Na mg/100kcal | Protein gm/100kcal |
Hills Science Diet Adult orig (dry) | 365kcal/cup | 59 | 6.3 |
Hills n/d | 569kcal/13oz can | 51 | 7.0 |
Royal Canin EC (dry) | 291 kcal/cup | 43 | 6.1 |
Purina JM (dry) | 351 kcal/cup | 40 | 7.9 |
Purina felin CV (can) | 223kcal/5.5oz can | 40 | 8.8 |
Iams max cal (can) | 333kcal/6oz can | 38 | 7.2 |
Low Sodium Treats
Dogs | kcal/treat | Na mg/treat |
Science Diet Adult Treats
(medium) |
20 | 13 |
Iams Original Form Biscuits
(small) |
22 | 10 |
Hill’s Presciption Diet K9
Treats |
13 | 5 |
Stewart Fiber Formula Dog
Biscuits (medium) |
25 | 5 |
Baby carrots | 4 | 4 |
Alpo Healthy Snacks Variety
Snaps with Real Meat |
13 | 1 |
Apple, 1 slice raw or
orange, 1 section |
10 | 0 |
Cats | kcal/treat | Na mg/treat |
Purina Whisker Lickin’s
Brand Crunchy Cat Treats Tartar Control(all flavors) |
3 | 3 |
Stewart Fiber Formula
Cat Treats |
1 | 1 |
Reference – various writings, lectures by J. Rush, DVM, MS, DACVIM (cardiology), DACVEC and L. Freeman, DVM, PhD, DACVN
Miscellaneous Foods and sodium content
Bread, Cereals and Potatoes | Sodium (mg) | Amount |
recommended: | ||
potato(small) | 1 | |
polished rice | ½ cup | 1-10 |
macaroni | 1 cup | 1-10 |
puffed wheat | 1oz | 1-10 |
spaghetti | 1 cup | 1-10 |
not recommended: | ||
bread | 1 slice | 200 |
pretzel | 1 | 275 |
Margarine and Oil
Sodium (mg) | Amount | |
Recommended: | ||
unsalted margarine | 1tsp | 0-1 |
vegetable shortening | 1 tbsp | 0-1 |
not recommended: | ||
mayonnaise | 1 tbsp | 60-90 |
Dairy Products
Sodium (mg) | Amount | |
not recommended: | ||
milk (regular) | 1 cup | 122 |
milk (skim) | 1 cup | 122 |
cream cheese | 1 1/2 oz | 100-120 |
cottage cheese | 3 oz | 200-300 |
american cheese | 1 oz | 200-300 |
butter | 1 tsp | 50 |
Meats, Poultry and Fish
Sodium (mg) | Amount | |
recommended: | ||
beef (fresh) | 3 1/2 oz | 50 |
pork (fresh) | 3 1/2 oz | 62 |
lamb (fresh) | 3 1/2 oz | 84 |
veal | 3 1/2 oz | 67 |
chicken (no skin) | ||
light meat | 3 1/2 oz | 64 |
dark meat | 3 1/2 oz | 86 |
turkey (no skin) | ||
light meat | 3 1/2 oz | 82 |
dark meat | 3 1/2 oz | 98 |
not recommended: | ||
egg | 1 | 70 |
bacon | 2 slices | 385 |
ham (processed) | 3 oz | 940 |
frankfurter | 1 | 560 |
Vegetables (fresh or dietetic canned)
Sodium (mg) | Amount | |
recommended: | ||
asparagus | <5 | 1/2 cup |
green beans | <5 | 1/2 cup |
peas | <5 | 1/2 cup |
green pepper | <5 | 1/4 cup |
tomato | <5 | 1 |
lettuce 1/4 head | <5 | |
corn | <5 | 1/2 cup |
cucumber | <5 | 1/2 cup |
Fresh fruits
Most are low in sodium and are permitted
Desserts
Sodium (mg) | Amount | |
recommended: | ||
sherbert | 1/2 cup | 15-25 |
not recommended: | ||
gelatins | 1/2 cup | 60-85 |
ice cream | 1/2 cup | 60-85 |
puddings | 1/2 cup | 100-200 |